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After Surviving Cancer, a Focus on True Manhood

By Dana Jennings February 15, 2010 3:51 pmFebruary 15, 2010 3:51 pm

Jeffrey Decoster

I’ve trudged through Stage 3 prostate cancer and its treatment in good shape. Nearly two years after learning I had cancer, I’m an active 52-year-old, I exercise regularly, my blood tests are where they need to be and my oncologist wants to see me only twice a year.

But there is one side effect of my treatment that has proved especially stubborn: erectile dysfunction.

After a radical open prostatectomy, radiation and hormone therapy, it’s still difficult to get the old engine of desire to turn over. And now that I’m dosing my post-treatment depression with Zoloft — which also disrupts sexual function — sometimes I can’t even find the key. Oh, and my testosterone level is low, too.

I’m not complaining, though. There’s no percentage in being erect and dead.

Prostate cancer and its treatment strike men where they live, often causing impotence and incontinence. (My bladder control gradually returned. But I can still be caught off guard by the stray sneaky sneeze.)

It’s not that I’m ready to fold up my tent. We are sexual creatures, after all, and I am working with my surgeon to reclaim that part of myself. In the past two years, though, I’ve insisted on trying to learn what having cancer could teach me. And here I’m just trying to understand, trying to articulate, what it feels like to be damaged goods in our oversexualized culture.

We founder in a mere surface culture of smirk, snark and innuendo. The greedy objectification of the body — in both women and men — accelerates, speeding so fast that the objections can’t even be heard over the roar of the mass media.

We are told to worship washboard abs and Everest biceps, improbably perky breasts and buns of titanium. It sometimes seems that every image spewed forth by the electronic media resonates with just one unsubtle subtext: sex.

Where does that leave a man who has erectile dysfunction?

I’m not so much interested in male biophysical mechanics, about Levitra and Viagra and Cialis (an erection that lasts more than four hours? How about four seconds?), about penile injections and pumps.

To me, the ads for the magic pills never seem to strike quite the right note. The men often look as furtive as teenagers buying condoms. And the narrators are hushed and ominous, like the voice-over in a campaign attack ad.

In the popular mind, manhood and womanhood have become ever more confused with the sexual act. But manhood isn’t about prodigious feats of lovemaking or how many partners you can bed. There are no official standings.

True manhood is about love and kindness. It’s about responsibility and honor, about working hard and raising your children the best way you know how, with love, respect and discipline.

Yes, my erectile function is still a work in progress, but I don’t feel diminished; I don’t feel that I’m less of a man. My voice is still as deep as a well, my eyes a steely blue. I still relish a strong stout, and I can hold forth on the arcane points of the safety blitz. (Though sometimes I am tempted to say, “It’s O.K., ladies, I’m harmless.”)

Libido comes and goes at odd hours, like a child home on a college break. But curiously, I feel that the life my wife, Deb, and I lead is more intimate than ever. I was the one who was sick, but we peered into the bleak chasms of cancer together. As I was buffeted by diagnosis, treatment and the aftermath, she was my advocate, my confidante, my unwavering caregiver. And everything she did was suffused by her love for me.

It was an intimacy beyond words. And believe me, I have a lot to live up to if the time comes for me to care for Deb.

True intimacy isn’t about the hydraulics of the flesh. It’s the smell of a certain shampoo in the hair, a passing touch in the kitchen, the taste of cold blueberry soup on a hot summer day, the gentle nostalgia of “Aja” by Steely Dan, and your heart melting at the sight of your wife of 28 years sound asleep after midnight — the murmur of HGTV having lulled her to slumber.

Despite everything that has happened the last couple of years, I’m a lucky man. I love my work, I’m blessed with two fine sons, and I have my compassionate and indispensable wife to snuggle with on these winter nights.

I’m only 32, and healthy as a horse. But if I am ever diagnosed with something serious, I can only hope to meet it with half the courage, forthrightness, and calm you have showed here over the past couple of years. You’ve done an excellent job chronicling the good, bad, and ugly of your illness, and I’m sure it is much-needed inspiration to thousands who are confronting the same issues.

Well said. I know there are many drawbacks to erectile dysfunction and loss of libido. But at the same time, think of how many people are at the mercies of their libidos — so obsessed with sex and sexuality that they fail to appreciate many of life’s little pleasures. So many people are obsessed with sex to the point that they’d destroy an extremely loving relationships for one night of pleasure with someone else, perhaps never knowing what they lost.
It sounds like there’s a silver lining in your plight. You truly love and appreciate your wife. You’re able to take pleasure in the subtle, non-sexual things that drive you crazy about her. Unlike a lot of men, you’re no longer at the mercy of your libido.
As a young, virile man who thinks about sex every ten seconds and fights hard to stay faithful to the wonderful woman in my life, in some ways I envy you.

Thank you for this article. Male sexuality is commonly misunderstood, stereotyped, and just not talked about. There are millions of men with sexual issues who are misunderstood and made to feel ashamed of something that may be entirely out of their control and totally natural.

We do indeed have an unrealistic, oversexualized culture. Throughout life, there are times where our sexual desires and abilities diminish. But is this something to be ashamed of or medicated for?

Depression, traumatic events, and cancer can all dramatically decrease someone’s sexuality. But even more mundane and normal events can as well, like not enough sleep, stress, sickness, getting older, poor relationships, and the list goes on. Should we label all these people with disorders and attack their sexualities with all of modern medicine’s tools? Or should we give each other a break and be more compassionate of human sexuality?

This also brings up many of the issues that people have with hypoactive sexual desire disorder.

As a couple in our 60’s, and thank goodness we do not have to deal with a horrible disease, we also have loss of libido that comes with the natural aging process. Although we miss the intimacy, we are just as close and loving as we were when we didn’ t have this as an issue.
We are still madly in love after 29 years together, and thank our stars every day for eachother. We cannot imagine life without the other and don’t even want to think about the certainty that one of us will be left alone someday.
I wish you a permanent recovery from the dreaded word cancer. You are truly blessed to have such a special and loving marriage. Look around you and see how many other couples are not as lucky as you are! Count your blessings and the happiness you wish for will eventually follow.

I had a masectomy in 2000 when my son was one year old. I was afraid to have reconstructive surgery at the same time, as is common for some women, because I wanted to heal quickly. Since then, I have had three recurrences of the cancer and two other surgeries. I never had reconstruction of my breast, I just have one breast and a huge scar on the other side. I have gained weight, too, from lack of exercise and lifestyle, but also from depression. I have been married for 14 years and my husband tries very hard to care of me. But I have not had sex in years. I miss it but I don’t feel I deserve it, because I am deformed and ugly. My husband never complains but sometimes I wonder how he feels about this. I think it is a terrible price we have paid, one of the horrors of cancer. Thank you for your honesty and beautiful writing.

Dana, I recommend that you look into the possibility of undergoing bioidentical hormone replacement therapy to address the symptoms of E.D. and depression due to your surgery and hormone suppression therapy.

I developed hypogonadism several years ago with symptoms that severely disabled me to the point that I could no longer work and I was barely functioning.

I had such a difficult time finding a doctor who knew how to treat me (I saw five health care professionals including two endocrinologists…) that I took it upon myself to study the available medical literature to help me separate fact from fiction.

After reading over three hundred medical studies, books and articles I am convinced that most doctors are unaware of the advancements made in recent years regarding the safe use of BHRT for men with symptoms due to low testosterone.

There is increasing evidence that testosterone does not contribute to the development of prostate cancer and that, in fact, normal testosterone levels help prevent cancer and heart disease, among other medical conditions.

I suggest reading “Testosterone For Life” by Dr. Abraham Morgentaler. Chapter 7 in particular covers in detail how the medical myth of the relationship of testosterone to prostate cancer came to be accepted as fact based on extremely limited and questionable medical evidence.

You don’t know what you are capable of unlesss and until you get off of SSRI’s. The sooner the better. More people loose libedo and erectile capabilities from anti-depressants than from surgery and no one talks about it because they are SOOOOO HAPPY they are no longer depressed and the drug literlly wipes out sexual desire so completely that no one is complaining. Literally millions are being permanently turned into eunics with these SSRI drugs and nothing is being siad about the distress that drove them to take them. Post-operative depression is the result of too much anesthesia for too long. Not suprising the nature of your operation stage 3. But you can swoon all you want about snuggling, get off the SSRI’s and the motor might turn over if you are one of the lucky 50% who recover from SSRI induced eunification within a year.
Try switching drugs to non-SSRI anti-depressants. Wellbutrin or Mertazapine.

When my father developed this problem, he had a pump put in as a present to my mother – whose attitude was “worked like a charm,” and “we feel like newly weds.” He died about 8 years ago @ 86, but until the last few weeks of his life, they had a very healthy and active sex life.

I’m up against stage four and still going strong after 4 plus years. Hormone treatment ended sex at the early age of 57. Depression has been a fight of it’s own. I can cry for a day with no reason. It’s not the prettyest life but the alternative is unacceptable. Excellent article, there are a lot of us out here, to many are in hiding.

Thanks for the thoughtful essay, Dana. I was diagnosed in October, but just underwent a repeat biopsy at Sloan-Kettering because I am a good candidate for active surveillance. I am still hoping the results of the 2nd biopsy say I can put off radical treatment…

But I am prepared to do what I have to do to stick around for my wife and son (he’s only 6). She has told me repeatedly that my presence is far more important than my tumescence, and if it comes to that I’ll find a way to show her I appreciate her saying so.